Mycetoma : a review

Am J Clin Dermatol. 2006;7(5):315-21. doi: 10.2165/00128071-200607050-00005.


Mycetoma is a chronic granulomatous infection that is present worldwide and endemic in tropical and subtropical regions. The infection is caused by the traumatic inoculation of a fungus (eumycetoma) or a bacterium (actinomycetoma) and generally remains localized, causing cutaneous and subcutaneous tissue swelling, nodule formation, and drainage through sinus tracts. This review details the history of mycetoma, which may date as far back as the Byzantine period (300-600 AD), the epidemiology of the disease, which is characterized by an endemic region located between the latitudes of 15 degrees south and 30 degrees north, and the clinical presentation and treatment of mycetoma, focusing on the differences between eumycete and actinomycete infections. Diagnosis is established by identifying the type of grains found in the discharge, which guides treatment. Mycetoma caused by bacteria can usually be managed effectively with antibacterial medication alone, while infections with fungi require antifungal medication and surgery. Without proper treatment, mycetoma can lead to deformity, amputation, and death.

Publication types

  • Review

MeSH terms

  • Actinomycetales Infections / diagnosis
  • Actinomycetales Infections / drug therapy*
  • Antifungal Agents / therapeutic use*
  • Diagnosis, Differential
  • Fungi / isolation & purification
  • Humans
  • Itraconazole / therapeutic use
  • Ketoconazole / therapeutic use
  • Mycetoma* / diagnosis
  • Mycetoma* / drug therapy
  • Mycetoma* / microbiology


  • Antifungal Agents
  • Itraconazole
  • Ketoconazole